Fenestrated endovascular repair for juxtarenal aortic pathology

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Presentation transcript:

Fenestrated endovascular repair for juxtarenal aortic pathology Thorarinn Kristmundsson, MD, Björn Sonesson, MD, PhD, Martin Malina, MD, PhD, Katarina Björses, MD, Nuno Dias, MD, PhD, Timothy Resch, MD, PhD Journal of Vascular Surgery Volume 49, Issue 3, Pages 568-575 (March 2009) DOI: 10.1016/j.jvs.2008.10.022 Copyright © 2009 The Society for Vascular Surgery Terms and Conditions

Fig 1 Maximum intensity projection reconstruction of an aortic aneurysm with very short infrarenal neck. Journal of Vascular Surgery 2009 49, 568-575DOI: (10.1016/j.jvs.2008.10.022) Copyright © 2009 The Society for Vascular Surgery Terms and Conditions

Fig 2 Fenestrated stent graft deployed with both renal arteries catheterized and renal sheaths in place. Journal of Vascular Surgery 2009 49, 568-575DOI: (10.1016/j.jvs.2008.10.022) Copyright © 2009 The Society for Vascular Surgery Terms and Conditions

Fig 3 Final angiogram showing good flow through renal stents and in superior mesenteric artery (SMA) which was incorporated into the graft with a non stented, reinforced scallop. Journal of Vascular Surgery 2009 49, 568-575DOI: (10.1016/j.jvs.2008.10.022) Copyright © 2009 The Society for Vascular Surgery Terms and Conditions

Fig 4 Kaplan-Meier estimate of the survival function for all cause mortality with numbers at risk inside the box. Twelve patients died during the follow-up period and 2 of those within 30 days of the initial procedure (3.7%). In total, three deaths were aneurysm-related. Journal of Vascular Surgery 2009 49, 568-575DOI: (10.1016/j.jvs.2008.10.022) Copyright © 2009 The Society for Vascular Surgery Terms and Conditions

Fig 5 Kaplan-Meier estimate of the re-intervention free survival with numbers at risk inside the box. During the first year of follow-up, two endoleaks (type I and II, respectively) were treated. One renal artery was embolized secondary to a massive bleeding on the first postoperative day. The patient died of complications. One patient developed acute ischemia in the right leg and was treated with thrombectomy and patch in the common femoral artery on postoperative day 115. The reason was stenos secondary to a Perclose suture. During the second year, one type II endoleak was treated and percutaneous transluminal angioplasty (PTA) was done on two stenosed renal arteries. Journal of Vascular Surgery 2009 49, 568-575DOI: (10.1016/j.jvs.2008.10.022) Copyright © 2009 The Society for Vascular Surgery Terms and Conditions